{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T18:30:44Z","timestamp":1774463444306,"version":"3.50.1"},"reference-count":13,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T00:00:00Z","timestamp":1600646400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T00:00:00Z","timestamp":1600646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Military Med Res"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Using ultrasound to measure optic nerve sheath diameter (ONSD) is an emerging bedside technique to noninvasively assess intracranial pressure (ICP) in patients with brain injury. This technique is unique among bedside ultrasonography and is often performed by providers who have no formal ultrasound training. We sought to create a low-cost, 3D, reusable ONSD model to train neurology, neurosurgery, and critical care providers in measuring ICP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 253 articles, of which 15 were associated with models and 2 with simulation. One gelatin model was reported, upon which we based our initial design. We could not validate the visual findings of this model; however, after constructing multiple beta models, the design most representative of human eye anatomy was a globe made of ballistics gel and either a 3\u2009mm, 5\u2009mm, or 7\u2009mm\u2009\u00d7\u200950\u2009mm 3D-printed optic nerve inserted into a platform composed of ballistics gel, all of which sat inside a 3D-printed skull. This model was used to teach ONSD measurements with ultrasound at a continuing medical education event prior to training on a live human model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A simple 3D ballistic ONSD model allows learners to practice proper hand placement and pressure, basic landmarks, and ONSD measurement prior to operating on a human eye. This model is replicable and sustainable given that the globe and platform are composed of ballistics gel.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40779-020-00274-4","type":"journal-article","created":{"date-parts":[[2020,9,20]],"date-time":"2020-09-20T21:02:21Z","timestamp":1600635741000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Creation of an optic nerve sheath diameter ultrasound model for NeuroICU education"],"prefix":"10.1016","volume":"7","author":[{"given":"Heidi M.","family":"Felix","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin A.","family":"Rosenbush","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy M.","family":"Lannen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Pooley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason L.","family":"Siegel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin L.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa L.","family":"McMullan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina I.","family":"Collins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William D.","family":"Freeman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","published-online":{"date-parts":[[2020,9,21]]},"reference":[{"key":"274_CR1","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1186\/1471-2377-13-187","volume":"13","author":"J Bauerle","year":"2013","unstructured":"Bauerle J, Schuchardt F, Schroeder L, Egger K, Weigel M, Harloff A. Reproducibility and accuracy of optic nerve sheath diameter assessment using ultrasound compared to magnetic resonance imaging. BMC Neurol. 2013;13:187.","journal-title":"BMC Neurol"},{"issue":"1","key":"274_CR2","doi-asserted-by":"publisher","first-page":"34","DOI":"10.3171\/jns.1997.87.1.0034","volume":"87","author":"HC Hansen","year":"1997","unstructured":"Hansen HC, Helmke K. Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: ultrasound findings during intrathecal infusion tests. J Neurosurg. 1997;87(1):34\u201340.","journal-title":"J Neurosurg"},{"key":"274_CR3","doi-asserted-by":"publisher","first-page":"51","DOI":"10.4103\/sni.sni_403_16","volume":"8","author":"MN Khan","year":"2017","unstructured":"Khan MN, Shallwani H, Khan MU, Shamim MS. Noninvasive monitoring intracranial pressure - a review of available modalities. Surg Neurol Int. 2017;8:51.","journal-title":"Surg Neurol Int"},{"issue":"5","key":"274_CR4","doi-asserted-by":"publisher","first-page":"E175","DOI":"10.1148\/rg.325115105","volume":"32","author":"RM Lorente-Ramos","year":"2012","unstructured":"Lorente-Ramos RM, Arm\u00e1n JA, Mu\u00f1oz-Hern\u00e1ndez A, G\u00f3mez JM, de la Torre SB. US of the eye made easy: a comprehensive how-to review with ophthalmoscopic correlation. Radiographics. 2012;32(5):E175\u2013200.","journal-title":"Radiographics."},{"issue":"3","key":"274_CR5","doi-asserted-by":"publisher","first-page":"406","DOI":"10.1007\/s12028-009-9250-8","volume":"11","author":"R Moretti","year":"2009","unstructured":"Moretti R, Pizzi B, Cassini F, Vivaldi N. Reliability of optic nerve ultrasound for the evaluation of patients with spontaneous intracranial hemorrhage. Neurocrit Care. 2009;11(3):406\u201310.","journal-title":"Neurocrit Care"},{"issue":"1","key":"274_CR6","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.ajem.2016.09.044","volume":"35","author":"M Raffiz","year":"2017","unstructured":"Raffiz M, Abdullah JM. Optic nerve sheath diameter measurement: a means of detecting raised ICP in adult traumatic and non-traumatic neurosurgical patients. Am J Emerg Med. 2017;35(1):150\u20133.","journal-title":"Am J Emerg Med"},{"issue":"3","key":"274_CR7","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1007\/s12028-011-9606-8","volume":"15","author":"V Rajajee","year":"2011","unstructured":"Rajajee V, Vanaman M, Fletcher JJ, Jacobs TL. Optic nerve ultrasound for the detection of raised intracranial pressure. Neurocrit Care. 2011;15(3):506\u201315.","journal-title":"Neurocrit Care"},{"issue":"3","key":"274_CR8","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1007\/s12028-011-9545-4","volume":"15","author":"JB Rosenberg","year":"2011","unstructured":"Rosenberg JB, Shiloh AL, Savel RH, Eisen LA. Non-invasive methods of estimating intracranial pressure. Neurocrit Care. 2011;15(3):599\u2013608.","journal-title":"Neurocrit Care"},{"key":"274_CR9","doi-asserted-by":"publisher","first-page":"1621428","DOI":"10.1155\/2017\/1621428","volume":"2017","author":"M Toscano","year":"2017","unstructured":"Toscano M, Spadetta G, Pulitano P, Rocco M, Di Piero V, Mecarelli O, et al. Optic nerve sheath diameter ultrasound evaluation in intensive care unit: possible role and clinical aspects in neurological critical patients' daily monitoring. Biomed Res Int. 2017;2017:1621428.","journal-title":"Biomed Res Int"},{"issue":"4","key":"274_CR10","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/j.jemermed.2014.09.060","volume":"48","author":"GW Hassen","year":"2015","unstructured":"Hassen GW, Bruck I, Donahue J, Mason B, Sweeney B, Saab W, et al. Accuracy of optic nerve sheath diameter measurement by emergency physicians using bedside ultrasound. J Emerg Med. 2015;48(4):450\u20137.","journal-title":"J Emerg Med"},{"issue":"1","key":"274_CR11","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1177\/0310057X1103900116","volume":"39","author":"DW Potgieter","year":"2011","unstructured":"Potgieter DW, Kippin A, Ngu F, McKean C. Can accurate ultrasonographic measurement of the optic nerve sheath diameter (a non-invasive measure of intracranial pressure) be taught to novice operators in a single training session? Anaesth Intensive Care. 2011;39(1):95\u2013100.","journal-title":"Anaesth Intensive Care"},{"issue":"2","key":"274_CR12","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1017\/S0317167100013779","volume":"40","author":"FA Zeiler","year":"2013","unstructured":"Zeiler FA, Unger B, Kramer AH, Kirkpatrick AW, Gillman LM. A unique model for ultrasound assessment of optic nerve sheath diameter. Can J Neurol Sci. 2013;40(2):225\u20139.","journal-title":"Can J Neurol Sci"},{"issue":"3","key":"274_CR13","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1001\/jamaophthalmol.2017.6560","volume":"136","author":"LJ Wang","year":"2018","unstructured":"Wang LJ, Chen LM, Chen Y, Bao LY, Zheng NN, Wang YZ, et al. Ultrasonography assessments of optic nerve sheath diameter as a noninvasive and dynamic method of detecting changes in intracranial pressure. JAMA Ophthalmol. 2018;136(3):250\u20136.","journal-title":"JAMA Ophthalmol"}],"container-title":["Military Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40779-020-00274-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40779-020-00274-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40779-020-00274-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T20:52:18Z","timestamp":1772830338000},"score":1,"resource":{"primary":{"URL":"https:\/\/mmrjournal.biomedcentral.com\/articles\/10.1186\/s40779-020-00274-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,21]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["274"],"URL":"https:\/\/doi.org\/10.1186\/s40779-020-00274-4","relation":{},"ISSN":["2054-9369"],"issn-type":[{"value":"2054-9369","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,21]]},"assertion":[{"value":"12 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 September 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 September 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"43"}}